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Drug Profile

The information on this site is intended to supplement and enhance, not replace, the advice of a physician who is familiar with your medical history. Decisions about your health should always be made ONLY after detailed conversation with your doctor.

Generic drug name: beclomethasone inhaled steroid (beh kloe METH a sone)
Brand name(s): QVAR AEROSOL
GENERIC: not available FAMILY: Inhaled Steroids
Find the drug label by searching at DailyMed.

Generic drug name: fluticasone propionate inhaled steroid (flue TIK a sone)
Brand name(s): ARMONAIR RESPICLICK, FLOVENT, FLOVENT DISKUS, FLOVENT HFA, FLOVENT ROTADISK
GENERIC: not available FAMILY: Inhaled Steroids
Find the drug label by searching at DailyMed.

Generic drug name: triamcinolone inhalation (trye am SIN oh lone)
Brand name(s): AZMACORT AEROSOL CANISTER
GENERIC: not available FAMILY: Inhaled Steroids
Find the drug label by searching at DailyMed.

Pregnancy and Breast-feeding Warnings [top]

Pregnancy Warning

Corticosteroids cause death and malformations in fetuses, including cleft palate, skeletal defects, and central nervous system and/or brain malformations. Because of the potential for serious adverse effects to the fetus, these drugs should not be used by pregnant women.

Breast-Feeding Warning

Corticosteroids are excreted in human milk. Because of the potential for adverse effects in nursing infants, you should not take these drugs while nursing.

Safety Warnings For This Drug [top]

FDA BLACK BOX WARNING

TRIAMCINOLONE

Particular care is needed in patients who are transferred from systemically active corticosteroids to Azmacort Inhalation Aerosol because deaths due to adrenal insufficiency have occurred in asthmatic patients during and after transfer from systemic corticosteroids to aerosolized steroids in recommended doses. After withdrawal from systemic corticosteroids, a number of months are usually required for recovery of hypothalamic-pituitary-adrenal (HPA) function (i.e., start producing your own corticosteroids after suppression by systemic corticosteroids). For some patients who have received large doses of oral steroids for long periods of time before therapy with Azmacort Inhalation Aerosol is initiated, recovery may be delayed for one year or longer. During this period of HPA suppression, patients may exhibit signs and symptoms of adrenal insufficiency when exposed to trauma, surgery, or infections, particularly gastroenteritis or other conditions with acute electrolyte loss. Although Azmacort Inhalation Aerosol may provide control of asthmatic symptoms during these episodes, in recommended doses it supplies only normal physiological amounts of corticosteroid systemically and does NOT provide the increased systemic steroid which is necessary for coping with these emergencies.

During periods of stress or a severe asthmatic attack, patients who have been recently withdrawn from systemic corticosteroids should be instructed to resume systemic steroids (in large doses) immediately and to contact their physician for further instruction. These patients should also be instructed to carry a warning card indicating that they may need supplementary systemic steroids during periods of stress or a severe asthma attack.

Do not stop any asthma medication without first consulting your physician. Abruptly stopping a medication may result in acutely deteriorating asthma control.

Additional Precautions for Asthma

Avoid exposure to things that trigger your allergies or asthma, such as animals, bedding, chemicals, cosmetics, drugs, dust, mold, foods, pollens, or smoke. Wearing a mask reduces inhalation of drugs, pollens, and smoke.

Aspirin can trigger asthma in people who are aspirin-allergic, as can beta-blockers. Infections aggravate lung problems. During epidemics of respiratory illnesses, avoid crowded places and wash your hands frequently to help prevent infection. If you have asthma, get a flu vaccination.

Note: The information in this profile addresses the care of asthma that is not serious enough to need emergency treatment.

Facts About This Drug [top]

Beclomethasone inhaled steroid (QVAR REDIHALER), fluticasone inhaled steroid (FLOVENT DISKUS, FLOVENT HFA) and triamcinolone inhalation (AZMACORT AEROSOL CANISTER) are steroids that have similar efficacy when inhaled.[1],[2] When used routinely, steroids inhaled by mouth prevent or reduce inflammation due to asthma. These drugs are not bronchodilators (drugs that open airways) and are not intended to treat acute asthma attacks or status asthmaticus.[3] However, they do reduce inflammation,...

Beclomethasone inhaled steroid (QVAR REDIHALER), fluticasone inhaled steroid (FLOVENT DISKUS, FLOVENT HFA) and triamcinolone inhalation (AZMACORT AEROSOL CANISTER) are steroids that have similar efficacy when inhaled.[1],[2] When used routinely, steroids inhaled by mouth prevent or reduce inflammation due to asthma. These drugs are not bronchodilators (drugs that open airways) and are not intended to treat acute asthma attacks or status asthmaticus.[3] However, they do reduce inflammation, improve lung function and reduce the number of acute asthma attacks.[2]

Asthma is a progressive disease that can develop at any age. Lung function declines and irreversible obstruction of the airways can occur. Diseases of the nose or sinuses and viral infections may worsen asthma.[4] Drugs control symptoms of asthma (shortness of breath, chest tightness, wheezing and coughing), but they do not cure the disease itself.

Steroids are available as aerosols or as dry powder to be inhaled through an accompanying device. Time for initial improvement varies from one to 14 days; full benefits take several weeks to months to occur. Proper technique in using the device delivering the steroid is important to the effectiveness of inhalers.[5]

Patients discontinuing use of oral steroids need to taper down the dose slowly and carefully under the supervision of a physician because it takes several months for adrenal function to recover. Deaths from adrenal insufficiency have occurred when the drug was tapered too quickly. Patients should be especially watchful if they experience trauma, surgery, infections or gastroenteritis while weaning off the drug.

Adverse effects

Although inhaled steroids reduce the likelihood of systemic effects, the risks are not eliminated.

Steroids can suppress natural adrenal gland hormone production and potentially change bone mineral density.[6],[7] Adrenal insufficiency can cause low blood sugar, unconsciousness, convulsions, coma or death. This also can occur during fasting or if steroids are stopped abruptly.[7]

A detachment of the retina called chorioretinopathy has been associated with steroid inhalers, especially in women.[8] There have been reports of cataracts in both children and adults using inhaled beclomethasone.[9]

A rare disease called Churg-Strauss syndrome, a condition in which blood vessels become inflamed, has been associated with both systemic and inhaled steroids.[10]

Steroids can slow growth and development in children. The safety and effectiveness of steroids in children under three months of age have not been established.

Steroids also can make you more susceptible to infections, which can lead to fungal infection of the mouth, throat and voice box called candidiasis or aspergillosis. The risk increases with higher doses, and may be higher with fluticasone.[11],[12] Patients can help reduce this risk by avoiding swallowing after rinsing their mouths. Children or adults who have not had chicken pox or measles should avoid exposure to these diseases.

The most frequently reported adverse effect associated with inhaled corticosteroid use in children with asthma is behavior alteration, according to researchers from the Netherlands. Researchers have received reports of behavioral changes in children associated with the use of inhaled fluticasone propionate or salmeterol/fluticasone propionate.[13],[14] The use of intranasal or inhaled corticosteroids appears to be associated with psychiatric disorders.[15],[16]

There have been 18 reports of skin bruising associated with the use of inhaled and/or intranasal fluticasone products.[17]

Studies say...

In onetrial comparing inhaled triamcinolone with a placebo (a pill with no medicinal effect), patients using triamcinolone experienced more skin adverse effects, such as bruising and delayed healing.[18]

Before You Use This Drug [top]

Do not use if you are:

  • pregnant or breast-feeding
  • allergic to lactose (fluticasone)

Tell your doctor if you have or have had:

  • glaucoma
  • infections (bacterial, fungal, parasitic, or viral)
  • liver problems, such as cirrhosis
  • osteoporosis
  • hypothyroidism
  • tuberculosis

Tell your doctor about any other drugs you take, including aspirin, herbs, vitamins, and other nonprescription products.

When You Use This Drug [top]

  • Request training for self-management of asthma.[19]
  • Read patient instructions carefully.
  • Limit exposure to triggers of asthma. Wear protective devices or masks. Stop smoking.
  • Avoid exposure to chicken pox or measles.
  • Contact your doctor if symptoms do not improve, or if you increase use of short-acting beta agonists.
  • If you are being transferred from systemic oral tablets of steroids to inhaled steroids, carry identification with you stating that supplemental systemic steroid therapy may be required in emergencies, periods of unusual stress, or acute asthma attack.
  • Use every day in regularly spaced doses.
  • Tell any doctor, dentist, emergency help, pharmacist, or surgeon you see that you use a steroid inhaler.

How to Use This Drug [top]

  • Do not use for acute attacks of asthma.
  • Success depends on technique. Follow printed instructions that accompany the particular inhaler device carefully about when and how to prime the container, inhalation technique by mouth, and disposal precautions.
  • Children should use a spacer device.
  • Do not spray in eyes or nose.
  • Gargle and rinse mouth with water after use. Spit out. Do not swallow. This reduces dry mouth, hoarseness, and risk of systemic absorption.
  • Schedule doses at even intervals.
  • If you miss a dose, take it as soon as you remember, but skip it if it is almost time for the next dose. Space any remaining doses of the day at regular intervals. Do not take double doses.
  • Do not stop taking this drug suddenly. Contact your doctor.
  • Do not share your medication with others.
  • Do not use actuator for other inhalation drugs.
  • Store inhalers in dry place at room temperature. Coldness can reduce the amount of drug inhaled. Do not freeze. Protect from sunlight. Do not use or store near heat or open flame. High temperatures may cause bursting. Keep out of reach of children for whom not prescribed.
  • Store fluticasone with nozzle end down.
  • Dispose after full number of actuations used or indicator reads zero. Follow accompanying instructions precisely. Do not throw into fire or incinerator. Do not reuse Diskus device.
  • The triamcinolone canister contains chlorofluorocarbon (CFC) as a propellant.

Interactions with Other Drugs [top]

Evaluations of Drug Interactions 2003 lists no drugs, biologics (e.g., vaccines, therapeutic antibodies), or foods as causing “highly clinically significant” or “clinically significant” interactions when used together with the drugs in this section. We also found no interactions in the drug’s FDA-approved professional package inserts. However, as the number of new drugs approved for marketing increases and as more experience is gained with these drugs over time, new interactions may be discovered.

Adverse Effects [top]

Call your doctor immediately if you experience:

  • aggressive behavior
  • anxiety
  • bleeding from rectum
  • blood pressure increase
  • difficult breathing
  • bruises
  • chest pain or burning
  • diarrhea
  • dizziness, fainting
  • fat deposits in face, neck, or trunk
  • fever
  • general feeling of discomfort or illness
  • slowed growth (children)
  • fast or irregular heartbeat
  • menstruation change
  • vaginal infection
  • mood or mental change
  • creamy-white patches in mouth or throat
  • nausea or vomiting
  • numbness
  • pain in abdomen, arms, back, chest, legs, ribs, or stomach
  • sense of constant movement of self or surroundings
  • diminished or lost senses of smell and taste
  • sinus problems
  • skin itching, hives, rash
  • bloody stools
  • painful swallowing or eating
  • swelling of ankles, eyelids, face, feet, fingers, lips, lower legs
  • unusual thirst
  • unusual tiredness or weakness
  • frequent, bloody, burning, or painful urination
  • blurred or changed vision
  • weight gain
  • severe wheezing
  • osteoporosis (occurs with long-term use; pain in back, ribs, arms, or legs)

Call your doctor if these symptoms continue:

  • sinus problems
  • cough
  • dry mouth or throat
  • headache
  • sore throat, hoarseness, or voice change
  • throat irritation
  • constipation
  • diarrhea
  • trouble sleeping
  • nausea or vomiting
  • unpleasant taste in mouth
  • nosebleeds or other nasal problems
  • general aches

Other adverse effects are possible. Contact your doctor with any concerns.

Periodic Tests[top]

Ask your doctor which of these tests should be done periodically while you are taking this drug:

  • adrenal function test
  • eye test
  • growth and development (in children)
  • lung function test
  • signs of bruising
  • test of technique in using inhaler
  • weight

last reviewed February 28, 2021